The retinal nerve fiber layer (RNFL) or nerve fiber layer, stratum opticum, is formed by the expansion of the fibers of the optic nerve; it is thickest near the

optic disc The optic disc or optic nerve head is the point of exit for ganglion cell axons leaving the eye. Because there are no rods or cones overlying the optic disc, it corresponds to a small blind spot in each eye. The ganglion cell axons form the ...

, gradually diminishing toward the

ora serrata The ora serrata is the serrated junction between the choroid and the ciliary body. This junction marks the transition from the simple, non-photosensitive area of the ciliary body to the complex, multi-layered, photosensitive region of the retina ...

. As the nerve fibers pass through the

lamina cribrosa sclerae The nerve fibers forming the optic nerve exit the eye posteriorly through a hole in the sclera that is occupied by a mesh-like structure called the lamina cribrosa. It is formed by a multilayered network of collagen fibers that insert into the sc ...

they lose their medullary sheaths and are continued onward through the

choroid The choroid, also known as the choroidea or choroid coat, is a part of the uvea, the vascular layer of the eye, and contains connective tissues, and lies between the retina and the sclera. The human choroid is thickest at the far extreme rear ...

and retina as simple axis-cylinders. When they reach the internal surface of the retina they radiate from their point of entrance over this surface grouped in bundles, and in many places arranged in

plexuses In neuroanatomy, a plexus (from the Latin term for "braid") is a branching network of vessels or nerves. The vessels may be blood vessels (veins, capillaries) or lymphatic vessels. The nerves are typically axons outside the central nervous system. ...

. Most of the fibers are centripetal, and are the direct continuations of the axis-cylinder processes of the cells of the

ganglionic layer The ganglion cell layer (ganglionic layer) is a layer of the retina that consists of retinal ganglion cells and displaced amacrine cells. The cells are somewhat flask-shaped; the rounded internal surface of each resting on the stratum opticum, and ...

, but a few of them are

centrifugal Centrifugal (a key concept in rotating systems) may refer to: *Centrifugal casting (industrial), Centrifugal casting (silversmithing), and Spin casting (centrifugal rubber mold casting), forms of centrifigual casting *Centrifugal clutch *Centrifug ...

and ramify in the

inner plexiform The inner plexiform layer is an area of the retina that is made up of a dense reticulum of fibrils formed by interlaced dendrites of retinal ganglion cells and cells of the inner nuclear layer The inner nuclear layer or layer of inner granules, o ...

and inner nuclear layers, where they end in enlarged extremities. Patients with retinitis pigmentosa have abnormal thinning of the RNFL which correlates with the severity of the disease. However the thickness of the RNFL also decreases with age and not visual acuity. The sparing of this layer is important in the treatment of the disease as it is the basis for connecting retinal prostheses to the optic nerve, or implanting stem cells that could regenerate the lost photoreceptors. RNFL is a sensitive structure which may vary based on ethnicity. Some process can excites its natural apoptosis. Harmful situation can make some damage on RNFL such as high intraocular pressure, high fluctuation on phase of intraocular pressure, inflammation, vascular disease and any kind of hypoxia. Gede Pardianto (2009) reported 6 cases of RNFL thickness change after the procedures of phacoemulsification. Sudden intraocular fluctuation in any kind of intraocular surgeries maybe harmful to RNFL in accordance with mechanical stress on sudden compression and also ischemic effect of micro emboly as the result of the sudden decompression that may generate micro bubble that can clog micro vessels.Pardianto G, Moeloek N, Reveny J, Wage S, Satari I, Sembiring R et al. Retinal thickness change after phacoemulsification. ''Clin Ophthalmol.'' 2013(7):2207-2214 Glaucoma is the lead cause of irreversible blindness in contemporary times. Furthermore, greater research in the RNFL and even optic nerve head (ONH) abnormalities, can pave the way for early detection and diagnosis of glaucoma Pattern of Retinal Nerve Fibers

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* {{Authority control Human eye anatomy